Comparison of Fibrinogen Concentrate and Cryoprecipitate on Major Thromboembolic Events after Living Donor Liver Transplantation

Jae-Hwan Kim; Kyoung-Sun Kim; Hye-Mee Kwon; Sung-Hoon Kim; In-Gu Jun; Jun-Gol Song; Gyu-Sam Hwang

doi:10.3390/jcm12237496

Comparison of Fibrinogen Concentrate and Cryoprecipitate on Major Thromboembolic Events after Living Donor Liver Transplantation

J Clin Med. 2023 Dec 4;12(23):7496. doi: 10.3390/jcm12237496.

Authors

Jae-Hwan Kim¹, Kyoung-Sun Kim¹, Hye-Mee Kwon¹, Sung-Hoon Kim¹, In-Gu Jun¹, Jun-Gol Song¹, Gyu-Sam Hwang¹

Affiliation

¹ Laboratory for Cardiovascular Dynamics, Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea.

Abstract

(1) Background: Liver transplantation (LT) is associated with significant hemorrhage and massive transfusions. Fibrinogen replacement has a key role in treating massive bleeding during LT and hypofibrinogenemia is treated by fibrinogen concentrate or cryoprecipitate. However, these two products are known to be associated with major thromboembolism events (MTEs). We aimed to compare the effect of fibrinogen concentrate and cryoprecipitate on MTEs in living donor LT (LDLT) recipients. (2) Methods: We analyzed 206 patients who underwent LDLT between January 2021 and March 2022. The patients were divided into two groups according to fibrinogen concentrate or cryoprecipitate use. We compared the incidence of MTEs between the two groups. In addition, we performed multiple logistic regression analyses to identify the risk factors for MTEs. (3) Results: There was no significant difference in the incidence of MTEs (16 [14.7%] vs. 14 [14.4%], p = 1.000) between the cryoprecipitate group and fibrinogen concentrate group. In the multivariate analysis, cryoprecipitate (OR 2.09, 95%CI 0.85-5.11, p = 0.107) and fibrinogen concentrate (OR 2.05, 95%CI 0.82-5.12, p = 0.126) were not significantly associated with MTEs. (4) Conclusions: there was no significant difference in the incidence of MTEs between cryoprecipitate and fibrinogen concentrate in LDLT recipients.

Keywords: fibrinogen; liver transplantation; mortality; thromboembolism.

Grants and funding

This research was supported by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (grant number: HR20C0026), and was also supported by grants (2023IE0008 and 2023IP0134) from the Asan Institute for Life Sciences, Asan Medical Center, Seoul, Korea.